【作者】 金珏；

【导师】 唐一源；

【作者基本信息】 大连理工大学 ， 生物物理， 2008， 硕士

【摘要】 近年来中国青年学生的心理问题越来越受到社会各界的重视,而心理问题的评估手段目前还主要停留在医生与咨询师的面谈方面,这种方法虽有其特异针对性的主观优势,但量化起来有困难,不易被重复、不易进行相互比较,而且既然心理问题是脑的机能,目前的评估手段还缺乏与心理问题密切相关的神经学资料。本文采用新近发展起来的无创或微创地可以对人活体大脑活动进行观察的脑功能成像技术[主要为单光子发射计算机断层显像技术(SPECT)],并辅助以专门设计的神经心理学范式,以及基于计算机科学发展起来的脑功能成像数据获取和识别系统、基于体素进行功能成像数据分析的统计参数图(SPM)图像数据处理方法,对当今中国青年学生发病率较高的焦虑、抑郁和进食障碍问题进行脑功能方面的评估,得出与健康对照相比,有心理问题的青年学生存在相应脑区局部脑血流的显著变化,如神经性厌食患者在与5-羟色胺(5-HT)和多巴胺(DA)神经递质有关的脑区存在脑血流异常,提示该病变与脑内神经递质的异常表达和代谢有关,属于素质相关性病变;同时,有心理问题的青年在认知行为方面也有缺损,如焦虑抑郁青年较健康对照相比,执行Go/Nogo任务时的行为表现显著较差,而且此类行为问题也反应在局部脑血流的变化上,具体体现在执行任务时,前扣带回和前额内侧、额下回外侧和胼胝体区域内的脑血流显著升高,提示这些部位的脑功能可能存在缺陷,说明焦虑抑郁青年有行为抑制方面的问题,而且该问题与特定部位的脑机制有关。本文不但详细阐述了脑功能成像技术在青年心理问题评估上的具体应用,还花了大量篇幅介绍脑功能成像数据的处理方法,使得该评估手段具有量化、可分析的特点,更加便于记录、比较和重复,为今后心理问题的辅助诊断奠定了基础。更多还原

【Abstract】 Mental health problems of young adults are widely recognized and attended. However, the assessment methods of such problems still stay in the stage of the interview by psychiatrists and psychological counselors. Although this kind of interview has some subjective advantages which deal with the mental health problems professionally and specifically, but some questions have not been answered yet, such as how to quantitate the mental process, how to make the interview or psychological examination repeated, how to compare two mental processes and so on. In addition, since the psychological process is the mechanism of the brain, the interview can not present us the neurological data.Single photon emission computerized tomography (SPECT), the newly developed non-or tiny invasive functional brain imaging technique has been used to explore the brain function in vivo in this research. The specifically designed neuropsychological paradigm was also included. The brain images were attained through the brain image attaining and discriminating computing system, and then were processed by the Statistical Parametric Mapping (SPM) on the basis of voxels. Anxiety, depression and eating disorder problems of young adults were assessed with these methods. Comparing to the healthy controls, the regional brain blood flow of those young adults with such mental health problems changes significantly. For example, the brain areas that relate to the 5-HT and dopamine functions have significant hypoperfusion or hyperperfusion in young adults with anorexia nervosa(AN), which indicates that AN’s incidence is associated with the dysfunction of certain neurotransmitters and/or receptors, and AN is trait-related. Furthermore, young adults with mental health problems have cognitive deficiency in some extent. For example, when performing Go/Nogo tasks, the behavioral performance of young adults with anxiety and depression is significantly worse than healthy controls. Also, the regional altered brain blood flow of these people showed the dysfunction in the certain brain areas. Hyperperfusion can be found in the areas of anterior cingulated cortex and medial prefrontal cortex, lateral inferior prefrontal cortex, as well as posterior corpus callosum when Go/Nogo task is performed. This result suggests young adults with anxiety and depression problems also have behavioral inhibitory dysfunction, which is related to the deficiency in the certain brain areas. This paper not only described the application of functional brain imaging to young adults’ mental health problems, but also illustrated the voxel-based data process methodology of functional brain data in large efforts. This research made a foundation of auxiliary diagnosis of mental health problems.更多还原